b'This states quite clearly that this code is used onlyare several red flags that may slow down the when the bone graft is placed at the same time asprocess of reimbursement. First is the patients the tooth or implant is removed.age. This is a procedure that is not normally The correct code in this instance is: performed on a teenager. It is also unusual if there is only one tooth missing. I assume D7950 osseous, osteoperiosteal or cartilagethere is no indication that periodontal disease graft of the maxilla or mandible, autogenousexists, so it cannot be submitted as treatment or non-autogenous, by reportof a vertical defect. D7950 is by report and This procedure is for ridge augmentation orI would send as much information as possible reconstruction to increase height, width and/ including radiographs, intraoral photographs, or volume of residual alveolar ridge. It includesand inform the carrier of the request for this obtaining graft material. Placement of a barriertreatment by the orthodontist. This may result membrane, if used, should be reported separately.in another issue; depending on the plans policy and limitations, treatment might be considered This is an unusual case; I would strongly recommendpart of the patients orthodontics benefit and that a pre-treatment estimate be obtained. Theremay have reached their maximum. The bottom line is to gather as much information as possible, both clinically during the evaluation and in the form of conversing with the carrier, and having a pre-treatment estimate prior to performing the treatmentSubmit your third-party questions to insurance@perio.org. Members with coding questions or difficulties with insurance claims can also contact the AAPs third-party specialist, Michelle Flesch, at 312-573-3241 or michellef@perio.org19'